Journal of Infection in Developing Countries
Volume 6, Issue 3, 2012, Pages 234-241

Epidemic cholera in Kakuma Refugee Camp, Kenya, 2009: The importance of sanitation and soap (Article)

Mahamud A.S. , Ahmed J.A. , Nyoka R. , Auko E. , Kahi V. , Ndirangu J. , Nguhi M. , Burton J.W. , Muhindo B.Z. , Breiman R.F. , Eidex R.B.
  • a Kenya Medical Research Institute/ Centers for Disease Control and Prevention, Department of Africa Refugee Health Program CDC-KEMRI, Kenya Medical Research Institute/CDC, Nairobi, Kenya
  • b US Centers for Disease Control and Prevention, Nairobi, Kenya
  • c US Centers for Disease Control and Prevention, Nairobi, Kenya
  • d Kenya Medical Research Institute/ Centers for Disease Control and Prevention, Department of Africa Refugee Health Program CDC-KEMRI, Kenya Medical Research Institute/CDC, Nairobi, Kenya
  • e International Rescue Committee, Nairobi, Kenya
  • f International Rescue Committee, Nairobi, Kenya
  • g International Rescue Committee, Nairobi, Kenya
  • h United Nations High Commissioner for Refugees, Nairobi, Kenya
  • i United Nations High Commissioner for Refugees, Nairobi, Kenya
  • j US Centers for Disease Control and Prevention, Nairobi, Kenya
  • k US Centers for Disease Control and Prevention, Nairobi, Kenya

Abstract

Introduction: Cholera remains a major public health problem that causes substantial morbidity and mortality in displaced populations due to inadequate or unprotected water supplies, poor sanitation and hygiene, overcrowding, and limited resources. A cholera outbreak with 224 cases and four deaths occurred in Kakuma Refugee Camp in Kenya from September to December 2009. Methodology: We conducted a case-control study to characterize the epidemiology of the outbreak. Cases were identified by reviewing the hospital registry for patients meeting the World Health Organization (WHO) case definition for cholera. For each case a matched control was selected. A questionnaire focusing on potential risk factors was administered to cases and controls. Results: From 18 September to 15 December 2009, a total of 224 cases were identified and were hospitalised at Kakuma IRC hospital. Three refugees and one Kenyan national died of cholera. V. cholerae O1, serotype Inaba was isolated in 44 (42%) out of 104 stool specimens collected. A total of 93 cases and 93 matched controls were enrolled in the study. In a multivariate model, washing hands with soap was protective against cholera (adjusted odds ratio [AOR] =0.25[0.09-0.71]; p<0.01), while presence of dirty water storage containers was a risk factor (AOR=4.39[1.12-17.14]; p=0.03). Conclusion: Provision of soap, along with education on hand hygiene and cleaning water storage containers, may be an affordable intervention to prevent cholera. © 2012 Mahamud et al.

Author Keywords

Sanitation cholera Kenya Soap Refugee

Index Keywords

medical record review vibrio cholerae hospitalization human Refugees feces analysis controlled study reservoir Kenya Vibrio cholerae O1 cholera Epidemics Young Adult sanitation hand washing school child hygiene Adolescent Humans male preschool child female risk factor Child, Preschool questionnaire Article disease control Questionnaires adult major clinical study serotype Handwashing world health organization Soaps Case-Control Studies case control study Child
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84858383486&partnerID=40&md5=5765fa03f6fc40614e9f0eb4e301ac31
ISSN: 20366590
Cited by: 31
Original Language: English